Monday, August 17, 2009

This Op-ed piece by Paul Krugman in the New York Times explains several varieties of approaches to health care provision and concludes that the proposals by the Democrats are closest not to the UK or Canada or France (all of which have more popular and more successful approaches than the US) but to Switzerland (which also is more popular and successful than the current US approach).

I have to admit that I had forgotten about the Swiss system (although I had heard about it). This is probably a good fit for the US. Like the US, Switzerland has a somewhat more conservative population than many industrialized countries. Like the US, Switzerland has a strong commitment to a free market political-economy. And like the US, Switzerland's political institutions are diffused and allow a wide range interest groups to block political changes - often resulting in policy approaches based on compromises between disparate ideological blocs.

In conclusion I believe that, if the Democrats can pull together and get this passed, they'll find the results safely popular.

9 comments:

There was a terrific Frontline a few months ago called "Sick Around the World" which profiled a few of the healthcare systems in industrialized countries. While the British and French systems didn't seem politically feasible, the Swiss system seemed like a great way to go from an American style "healthcare" system to a more humane approach.

"Safely popular" and "sacrosanct but despised" are two ways of saying the same thing. There will be enough people who like the program to keep it solidly in place despite some who might want to do away with it.

I meant to distinguish, RBR, between people liking the program (it being something "popular") and people bitching about it constantly, even though they want to keep it. The former is more of a political asset than the latter.

But my point is that there will be people who like it. Just like there are people who like SS and Medicare. Of course there will be people who hate it all too. But they will be unable to get past the people for whom the program is popular and so it will be safe.